Die Qualität von Vollblut in Abhängigkeit von Herstellungsverfahren (Leukozytendepletion) und Lagerungsdauer. Bedeutung für die operationsvorbereitende Eigenblutspende*

Abstract

Several parameters indicating quality of stored blood were constant in whole blood independent of the kind of preparation during a storage of 49 days. This is in contrast to the main part of specific scientific communications. A beneficial influence of leukocyte depletion was observed for some coagulation parameters whereas increasing characteristics of activated coagulation in CPDA1-stored whole blood at the end of storage time had to be observed. The preparation of whole CPDA1-blood is recommended for autologous predonation, if storage time does not exceed 30 days. Storage time of > 40 days seems to be possible for autologous whole blood after filtration for leucocyte depletion.

The Type of Storage of Autologous Blood Does Not Influence Homologous Transfusion Requirements in Hip Arthroplasty

“…The coagulation factors V and VIII decreased to about 20% of normal in group WB and were considerably better preserved in group ldWB. Similar or slightly higher concentrations were found in other studies after the same time of storage [14,30,31]. Fibrin monomers and prothrombin fragments F1-2 show that there is little evidence for activation of the (terminal) coagulation cascade in most units of groups WB and PRC/FFP; in some there is a moderate increase.…”

“…In group ldWB no values above the normal range were found. This corresponds to the findings of another investigation comparing whole blood with leukocyte-depleted whole blood [30]. Elevated levels of prothrombin fragments and thrombin-antithrombin III complex (TAT) were found in CPD plasma immediately after separation into components, suggesting activation of the coagulation cascade that occurs already prior to storage [53].…”

“…The attending anesthetist and orthopedic surgeons, however, were not aware of the major aim of the study (homologous transfusion rate) but were informed about the minor aim only (parameters of quality of the stored blood). Bias usually does not extend beyond the major aim of the study and therefore is not expected to influ- [30,31,47]. ATP content of the erythrocytes was similar in all groups and within the range previously described or higher [30,48,49].…”

“…Bias usually does not extend beyond the major aim of the study and therefore is not expected to influ- [30,31,47]. ATP content of the erythrocytes was similar in all groups and within the range previously described or higher [30,48,49]. 2,3-DPG content was very low in all groups.…”

“…Permissible shelf time was utilized to the extent feasible in clinical routine, surgery was carried out in the 5th, 6th and 7th week in groups WB, ldWB and PRC/FFP, respectively. For group ldWB the recommended storage time of 5 weeks was exceeded by 1 week since recent studies show that parameters indicating quality of red cells are well preserved at storage times up to 49 days [30,31]. The transfusion of autologous plasma for volume substitution -and not for replacement of coagulation factors -is not in ac- The quality parameters determined on days 35, 42 and 49 in the unit donated first (first 10 patients in each group) are shown in table 3.…”